Avaliação da influência dos fatores socioeconômicos, demográficos e climáticos na morbimortalidade por paracoccidioidomicose no estado de São Paulo

Abstract

Paracoccidioidomycosis (PCM) is an endemic fungal disease in Latin America that occurs in socially disadvantaged regions. It is a disease with a significant impact on public health, as it is the eighth cause of death from infectious and parasitic diseases in Brazil. In this context, the state of São Paulo (SP) stands out as the federative unit with the highest number of cases. Therefore, the aim of this work was to verify whether hospitalization and mortality rates due to PCM in SP between the years 2006 and 2020 are under anthropogenic and climatic influence. Health information (number of hospitalizations and deaths due to PCM), socioeconomic, demographic and climatic conditions were collected via national secondary databases and analyzed using Spearman correlation and multiple regression tests. The correlation analysis revealed that social variables have a significant impact on PCM morbidity and mortality, with access to public health services being the most important. Living in small urban centers with less access to health services appears to be an important predictor of PCM. In terms of the other variables, weak positive correlations were found for the production of some crops and for temperature. Rainfall was weakly and negatively correlated with hospitalizations and deaths. The multiple regression model strengthened the influence of access to SUS, temperature and socio-demographic variables in the epidemiological context of PCM. Our results suggest that hospitalizations and deaths due to PCM are an important indicator of social vulnerability in São Paulo. Therefore, our study emphasizes the importance of interventions to mitigate the social and environmental impact of this disease, especially in municipalities with low socioeconomic levels.